The children on my father’s side of the family seem to have a high risk of developing childhood arthritis. No one seems to know why. Once we start to have children, is there some way to tell early on if they are going to get this problem?

There is no screening test that shows the presence of juvenile idiopathic arthritis or JIA as it is now called. This condition used to be referred to as juvenile rheumatoid arthritis. Idiopathic is a term that suggests “no known cause.”

In fact the lack of a screening test has made this condition difficult to diagnose. Even tests that are used reliably with adults to look for rheumatoid arthritis (e.g., rheumatoid factor, antinuclear antibody or ANA) are usually negative in children or are a false-positive.

False positive means the test is positive when there is no rheumatologic disease present at all. X-rays and other imaging studies have equally limited value. The diagnosis really depends on the child’s history and clinical presentation.

So there’s no way to predict ahead of time who might develop this condition. But knowing there is a positive family history on the paternal (father’s) side will alert you to watch for any signs and symptoms that might require further evaluation.

For example, persistent joint swelling and loss of motion in at least one and up to four joints for six weeks or more is a red flag. Morning stiffness and limping are more common than actual pain. The child feels well and does not complain of fatigue.

There are several subtypes of juvenile idiopathic arthritis (JIA) but the majority of children with this condition are girls. For every one male with JIA, there are five girls affected. The first symptoms start to show up early (ages one to three). The knee and ankle are involved most often.

Alert your pediatrician to your concerns and let him or her watch for any indications that there is a problem developing. Juvenile idiopathic arthritis is not an emergency situation. Early identification treatment are helpful and you are ready for that.